Comparison Of The Efficacy Of Two Different Sandwich Injection Methods For Gastric Varices Using Tissue Adhesive

Objective:To compare the efficacy of two different sandwich injection methods:lipiodol plus tissue adhesive and lauromacrogol plus tissue adhesive for the treatment of gastric varices,in search of a better treatment of endoscopic injection for gastric varices.Methods:The data of 82 patients with gastric varices who received endoscopic tissue adhesive injection between January 2008 and June 2015 were collected.35 cases were treated with the traditional sandwich injection method(lipiodol-tissue adhesive-lipiodol),while 47 cases were treated with lauromacrogol combined with tissue adhesive(lauromacrogol-tissue adhesive-auromacrogol).They all received a follow up after one year.The rate of hemostasis,the amount of tissue adhesive used,the rate of eradication of the varices after one week,the incidence of complications as well as the incidence of rebleeding in one year were compared between the two groups.Results:The rate of hemostasis in both groups was 100%.The volume of tissue adhesive used in the lauromacrogol sandwich injection group was less than that used in the lipiodol sandwich injection group(1.82ml±0.73ml vs 3.56ml±1.39ml).Significant differences were observed between the two groups(p=0.000).The postoperative variceal disappearance rate(17.1%vs 21.3%)and the incidence of rebleeding(36.2%vs 34.3%)were almost similar between the two groups,the differences were not statistically significant(p>0.05).There was a statistical difference in the incidence of complications between the two groups(2.1%vs 25.7%)(p<0.05).Conclusion:Sandwich injection using lauromacrogol for the treatment of gastric varices offers similar efficacy compared to the lipiodol method,but with less side effects It also reduces the volume of tissue adhesive required,thus decreasing the cost of treatment.